Sun Ling-Yue, Qu Xiang, Chen Ling-Zhi, Chen Xing-Xing, Zheng Gao-Shu, Wang Zhi-Ting, Huang Wei-Jian, Zhou Hao
Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
Department of Clinical Laboratory, Wenzhou Central Hospital, Wenzhou, 325000, Zhejiang, China.
Heart Vessels. 2017 Dec;32(12):1506-1512. doi: 10.1007/s00380-017-1019-y. Epub 2017 Jul 8.
Heart failure (HF) has a significant effect on the prognosis of the patients with atrial fibrillation (AF), and also it is an important risk factor for overall mortality. High molecular weight fibroblast growth factor-2 (Hi-FGF-2) is emerging as a prognostic marker with HF and AF. The aim of this study was to prove that Hi-FGF-2 would predict occurrence of HF in the patients with AF. Subjects diagnosed with paroxysmal AF (Group paAF), persistent AF (Group peAF) and sinus rhythm (Group SR) were enrolled in the study. Serum Hi-FGF-2 concentration was measured by ELISA at baseline. Multivariable logistic models and receiver operating characteristic (ROC) curve analysis were established to predict the prognosis of AF subjects. 260 patients were enrolled in the study: 104 (40.0%) admitted for sinus rhythm (Group SR) and 156 (60.0%) with AF (Group paAF and Group peAF). The Hi-FGF-2 levels were much lower in the Group SR (58.2 ± 27.1 ng/L) than in the Group AF. Furthermore, the Group peAF (84.3 ± 34.1 ng/L) had higher Hi-FGF-2 levels than the Group paAF (72.9 ± 35.8 ng/L). Serum Hi-FGF-2 levels were classified into trisection in the multivariable logistic model (T1 < 57.3 ng/L, 57.3 < T2 < 86.5 ng/L, and T3 > 86.5 ng/L). Hi-FGF-2 showed good predictive ability for new-onset HF in the patients with AF. The occurrence of HF was associated significantly with increased tertile of serum Hi-FGF-2 levels (T2: OR 5.922, 95% CI 1.109-31.626, P = 0.037 and T3: OR 8.262, 95% CI 1.735-39.343, P = 0.008). ROC curve analysis showed that the area under curves for Hi-FGF-2 were 0.720 (P < 0.0001). Hi-FGF-2 has a significant meaning in AF subjects. Further to this, higher circulating Hi-FGF-2 was highly related to persistent AF, and Hi-FGF-2 may be an independent risk factor of occurrence HF in AF subjects.
心力衰竭（HF）对心房颤动（AF）患者的预后有显著影响，也是总体死亡率的重要危险因素。高分子量成纤维细胞生长因子-2（Hi-FGF-2）正逐渐成为HF和AF的一种预后标志物。本研究的目的是证明Hi-FGF-2可预测AF患者发生HF的情况。诊断为阵发性AF（阵发性AF组）、持续性AF（持续性AF组）和窦性心律（窦性心律组）的受试者纳入本研究。在基线时通过酶联免疫吸附测定法（ELISA）测量血清Hi-FGF-2浓度。建立多变量逻辑模型和受试者工作特征（ROC）曲线分析以预测AF受试者的预后。260例患者纳入本研究：104例（40.0%）因窦性心律入院（窦性心律组），156例（60.0%）为AF患者（阵发性AF组和持续性AF组）。窦性心律组的Hi-FGF-2水平（58.2±27.1 ng/L）远低于AF组。此外，持续性AF组（84.3±34.1 ng/L）的Hi-FGF-2水平高于阵发性AF组（72.9±35.8 ng/L）。在多变量逻辑模型中，血清Hi-FGF-2水平被分为三等分（T1<57.3 ng/L，57.3<T2<86.5 ng/L，T3>86.5 ng/L）。Hi-FGF-2对AF患者新发HF具有良好的预测能力。HF的发生与血清Hi-FGF-2水平三分位数增加显著相关（T2：比值比5.922，95%置信区间1.109 - 31.626，P = 0.037；T3：比值比8.262，95%置信区间1.735 - 39.343，P = 0.008）。ROC曲线分析显示，Hi-FGF-2的曲线下面积为0.720（P<0.0001）。Hi-FGF-2在AF受试者中有重要意义。此外，循环中较高的Hi-FGF-2与持续性AF高度相关，Hi-FGF-2可能是AF受试者发生HF的独立危险因素。
